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Lithium monitoring patterns in the United Kingdom and Ireland: Can shared care agreements play a role in improving monitoring quality? A systematic review

Published online by Cambridge University Press:  21 February 2017

R. E. Aubry ,
L. Scott  and
E. Cassidy
R. E. Aubry*
Affiliation:
Graduate Entry Medicine, University College Cork, Cork, Ireland
L. Scott
Affiliation:
Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork.
E. Cassidy
Affiliation:
Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork.
*
*Address for correspondence: R. E. Aubry, Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland. (Email: R.Aubry@tiptv.net)
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Abstract

Background

The appropriate monitoring of patients on lithium therapy has been the subject of extensive research in the form of clinical audits and surveys culminating in the development of specific guidelines to help clinicians provide optimal care for patients on lithium. The concept of ‘shared care’ has also gained attention in the literature with various types of shared care interventions being introduced as potential ways of improving communication between primary and secondary care.

Objectives

This article aims to (1) review the literature evaluating lithium monitoring practices in the United Kingdom and Ireland in the last 25 years and (2) determine whether locally agreed shared care agreements have the potential to improve monitoring quality.

Methods

A literature search was conducted using the following databases: PubMed, Scopus, Web of Science, Academic Search Premier, CINAHL and PsychInfo. A total of 12 studies were selected for review including 11 audits/prospective chart reviews and one qualitative study using semi-structured interviews.

Conclusions

Overall, the quality of lithium monitoring seems to be improving throughout the years. However, none of the studies reviewed revealed complete adherence to monitoring guidelines. This may be due to a lack of effective communication between primary and secondary care. Several shared care interventions have been described in the literature but there is a paucity of studies concerned with the effects of local shared care arrangements designed for the specific purpose of lithium monitoring. Nonetheless, the extant data suggests that such agreements may help improve monitoring standards by allowing the responsibilities for managing the prescribing and monitoring of lithium to be more clearly defined and shared between primary and secondary care.

Keywords

Drug monitoringlithium therapymental healthprimary careshared care
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 34 , Issue 2 , June 2017 , pp. 127 - 140
Copyright
© College of Psychiatrists of Ireland 2017 

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References

Baastrup, PC, Poulsen, JC, Schou, M, Thomsen, K, Amdisen, A (1970). Prophylactic lithium: double blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet 2, 326–330.Google Scholar
Baldessarini, RJ, Tondo, L, Davis, P, Pompili, M, Goodwin, FK, Hennen, J (2006). Decreased risk of suicides and attempts during long-term lithium treatment: a meta-analytic review. Bipolar Disorders 8, 625–639.Google Scholar
Barraclough, B (1972). Suicide prevention, recurrent affective disorder and lithium. The British Journal of Psychiatry 121, 391–392.Google Scholar
Bauer, M, Adli, M, Bschor, T, Pilhatsch, M, Pfennig, A, Sasse, J, Schmid, R, Lewitzka, U (2010). Lithium’s emerging role in the treatment of refractory major depressive episodes: augmentation of antidepressants. Neuropsychobiology 62, 36–42.Google Scholar
Bauer, M, Dopfmer, S (1999). Lithium augmentation in treatment-resistant depression: meta-analysis of placebo-controlled studies. Journal of Clinical Psychopharmacology 19, 427–434.Google Scholar
Bauer, M, Pfennig, A, Severus, E, Whybrow, PC, Angst, J, Möller, HJ (2013). World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders, part 1: update 2013 on the acute and continuation treatment of unipolar depressive disorders. The World Journal of Biological Psychiatry 14, 334–385.Google Scholar
Bschor, T (2014). Lithium in the treatment of major depressive disorder. Drugs 74, 855–862.Google Scholar
Buckley, C, Sharrard, H (2003). Lithium monitoring for patients with learning disability: the role of the general practitioner. Quality in Primary Care 11, 329–331.Google Scholar
Burgess, S, Geddes, J, Hawton, K, Taylor, MJ, Townsend, E, Jamison, K, Goodwin, G (2001). Lithium for maintenance treatment of mood disorders. The Cochrane Database of Systematic Reviews 2001, Cd003013.Google Scholar
Butler, JA, Taylor, D (2000). A survey of lithium monitoring and prescribing patterns. International Journal of Psychiatry in Clinical Practice 4, 135–138.Google Scholar
Cipriani, A, Hawton, K, Stockton, S, Geddes, JR (2013). Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ 346, f3646.Google Scholar
Cipriani, A, Pretty, H, Hawton, K, Geddes, JR (2005). Lithium in the prevention of suicidal behavior and all-cause mortality in patients with mood disorders: a systematic review of randomized trials. The American Journal of Psychiatry 162, 1805–1819.Google Scholar
Cipriani, A, Smith, K, Burgess, S, Carney, SM, Goodwin, G, Geddes, J (2006). Lithium versus antidepressants in the long-term treatment of unipolar affective disorder. The Cochrane Database of Systematic Reviews 2006, Cd003492.Google Scholar
Collins, N, Barnes, TR, Shingleton-Smith, A, Gerrett, D, Paton, C (2010). Standards of lithium monitoring in mental health trusts in the UK. BMC Psychiatry 10, 80.Google Scholar
Crowe, S, Cantrill, JA, Tully, MP (2010). Shared care arrangements for specialist drugs in the UK: the challenges facing GP adherence. Quality & Safety in Health Care 19, 1–5.Google Scholar
De Montigny, C, Grunberg, F, Mayer, A, Deschenes, JP (1981). Lithium induces rapid relief of depression in tricyclic antidepressant drug non-responders. British Journal of Psychiatry 138, 252–256.Google Scholar
Dennison, U, Clarkson, M, O’Mullane, J, Cassidy, EM (2011). The incidence and clinical correlates of lithium toxicity: a retrospective review. Irish Journal of Medical Science 180, 661–665.Google Scholar
Eagles, JM, McCann, I, MacLeod, N, Paterson, N (2000). Lithium monitoring before and after the distribution of clinical practice guidelines. Acta Psychiatrica Scandinavica 101, 349–353.Google Scholar
Foy, R, Hempel, S, Rubenstein, L, Suttorp, M, Seelig, M, Shanman, R, Shekelle, PG (2010). Meta-analysis: effect of interactive communication between collaborating primary care physicians and specialists. Annals of Internal Medicine 152, 247–258.Google Scholar
Geddes, JR, Burgess, S, Hawton, K, Jamison, K, Goodwin, GM (2004). Long-term lithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials. The American Journal of Psychiatry 161, 217–222.Google Scholar
Glover, KJ, Lawley, D (2005). How safe is lithium prescribing? Audit of a local prescribing framework and patient survey. Psychiatric Bulletin 29, 98–100.Google Scholar
Glynn, L (2006). A critical appraisal tool for library and information research. Library Hi Tech 24, 387–399.Google Scholar
Hickman, M, Drummond, N, Grimshaw, J (1994). A taxonomy of shared care for chronic disease. Journal of Public Health Medicine 16, 447–454.Google Scholar
HSE National Vision for Change Working Group (2013). Advancing the shared care approach between primary care & specialist mental health services: a guidance paper (http://www.hse.ie/eng/services/Publications/Mentalhealth/Sharedcareguidancepaper.html). Accessed 23 March 2016.Google Scholar
Irish Medication Safety Network (IMSN) (2012). Best practice for prescribing and monitoring of lithium therapy (http://www.imsn.ie/images/guidelines/imsn-lithium-guidelines-may-2012.pdf). Accessed 23 March 2016.Google Scholar
Kehoe, RF, Mander, AJ (1992). Lithium treatment: prescribing and monitoring habits in hospital and general practice. British Medical Journal 304, 552–554.Google Scholar
Keogh, F (2009). From vision to action? An analysis of the implementation of a vision for change. Mental Health Commission, Dublin (http://www.mhcirl.ie/File/VtoA_Imp_VforC.pdf). Accessed 16 March 2016.Google Scholar
Kessing, LV, Søndergård, L, Kvist, K, Andersen, PK (2005). Suicide risk in patients treated with lithium. Archives of General Psychiatry 62, 860–866.Google Scholar
Kirkham, E, Bazire, S, Anderson, T, Wood, J, Grassby, P, Desborough, JA (2013). Impact of active monitoring on lithium management in Norfolk. Therapeutic Advances in Psychopharmacoly 3, 260–265.Google Scholar
Kuper, A, Lingard, L, Levinson, W (2008). Critically appraising qualitative research. BMJ 337, a1035.Google Scholar
Lauterbach, E, Felber, W, Muller-Oerlinghausen, B, Ahrens, B, Bronisch, T, Meyer, T, Kilb, B, Lewitzka, U, Hawellek, B, Quante, A, Richter, K (2008). Adjunctive lithium treatment in the prevention of suicidal behaviour in depressive disorders: a randomised, placebo-controlled, 1-year trial. Acta Psychiatrica Scandinavica 118, 469–479.CrossRefGoogle ScholarPubMed
Mental Health Reform (2015). A vision for change nine years on: a coalition analysis of progress. Mental Health Reform, Dublin (http://www.drugsandalcohol.ie/24033/1/A-Vision-for-Change-web-final.pdf). Accessed 29 April 2016.Google Scholar
Moher, D, Liberati, A, Tetzlaff, J, Altman, DG, The PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6, e1000097.Google Scholar
Muller-Oerlinghausen, B, Lewitzka, U (2010). Lithium reduces pathological aggression and suicidality: a mini-review. Neuropsychobiology 62, 43–49.Google Scholar
National Institute for Health and Care Excellence (NICE) (2014). Bipolar disorder (update): the management of bipolar disorder in adults, children and adolescents in primary and secondary care, Clinical Guideline No. 185 (https://www.nice.org.uk/guidance/CG185). Accessed 22 March 2016.Google Scholar
National Patient Safety Agency (NPSA) (2009). Safer lithium therapy. Patient safety alert NPSA 2009/PSA005 (www.nrls.npsa.nhs.uk/resources/type/alerts/?entryid45=65426). Accessed 10 April 2016.Google Scholar
Paton, C, Adroer, R, Barnes, TR (2013). Monitoring lithium therapy: the impact of a quality improvement program in the UK. Bipolar Disorders 15, 865–875.Google Scholar
Ryman, A (1997). Lithium monitoring in hospital and general practice. Psychiatric Bulletin 21, 570–572.Google Scholar
Smith, SM, Allwright, S, O’Dowd, T (2008). Does sharing care across the primary-specialty interface improve outcomes in chronic disease? A systematic review. American Journal of Managed Care 14, 213–224.Google Scholar
Udumaga, E, Mannion, L (2010). An audit in general adult psychiatry service. Irish Medical Journal 103, 123–124.Google Scholar
Yatham, LN, Kennedy, SH, Parikh, SV, Schaffer, A, Beaulieu, S, Alda, M, O’Donovan, C, MacQueen, G, McIntyre, RS, Sharma, V, Ravindran, A (2013). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disorders 15, 1–44.Google Scholar
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